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Is there still a place for Whipple's operation?
The Netherlands Journal of Surgery
|June 1, 1985
Summary
Pancreatoduodenectomy offers the only cure for ampullary or distal bile duct tumors. However, pancreatic cancer patients have poor survival rates, with high recurrence after surgery.
Area of Science:
- Gastroenterology and Hepatology
- Surgical Oncology
Background:
- Pancreatoduodenectomy is a complex surgical procedure.
- Malignancies of the pancreas, bile duct, and ampulla of Vater are serious conditions.
Purpose of the Study:
- To evaluate the outcomes of pancreatoduodenectomy for pancreatic cancer, distal common bile duct cancer, and ampulla of Vater carcinoma.
- To assess patient survival rates and local tumor recurrence after pancreatoduodenectomy.
Main Methods:
- Retrospective analysis of 42 patients who underwent pancreatoduodenectomy over 12 years.
- Data collection on patient demographics, diagnosis, surgical outcomes, survival, and recurrence.
Main Results:
- Postoperative mortality was 11% for pancreatic cancer and 28% for pancreatitis.
- No pancreatic cancer patients survived one year; 7/11 distal common bile duct cancer and 5/7 ampulla of Vater carcinoma patients survived one year.
- Local tumor recurrence was observed in 67% of patients, with laparotomy scar recurrence in three cases.
Conclusions:
- Resection provides the only curative option for ampullary or distal common bile duct tumors.
- Pancreatoduodenectomy is not currently the primary treatment for pancreatic cancer due to poor survival and high recurrence rates.